‘Sustainable’ change needed for addicts
Experts call for treatment overhaul as overdose deaths in first nine months of 2016 rise by 61 per cent
An overhaul of British Columbia’s “dysfunctional” addiction-treatment system must become top priority as drug users struggle to stay alive through an overdose crisis, recovery experts say.
In the first nine months of 2016, 555 people died of drug overdoses in the province, up 61 per cent over the same period last year, according to a B.C. Coroners Service report last week. Overdoses killed 56 people in September, up from 49 in August.
The highly toxic opioid fentanyl — which dealers are cutting into street drugs of all kinds — was detected in 61 per cent of these cases.
Marshall Smith, chair of the B.C. Recovery Council, believes the latest statistics prove there’s a critical need for more treatment options tailored to the widely varying needs of substance users in B.C.
“Right now in British Columbia and for the last several decades, we haven’t had an appropriate system of care designed to help people with addiction disorders all along the spectrum,” Smith said.
He believes there’s a need for more treatment services specifically for women, youth and aboriginal people and a system to help them navigate the treatment-service options.
According to the coroner’s report, 20 per cent of those who died of an overdose were women, eight people were 18 years old or younger and death rates per 100,000 population were similar in health regions across the province. Fentanyl is showing up in the blood of cocaine, amphetamine and opioid users.
But many of these drug users and their families don’t know where to turn for help, Smith said.
“They don’t know who to call. They wind up getting on the computer and Googling ‘rehab help’ because where do you start? And often they are making decisions regarding the care of their loved one or their employee based on second-hand information.”
He believes reform of the addiction-treatment system needs to happen soon, but at a pace that results in something “real, sustainable and lasting.”
He believes the government is responding appropriately to the crisis and commended Premier Christy Clark for setting up a panel of experts to study overdose response and for her announcement last month that her government would spend $5 million to launch a B.C. Centre on Substance Use to do addiction research, educational campaigns and provide guidance to medical professionals.
Dr. Keith Ahamad, a scientist with the B.C. Centre for Excellence in HIV/AIDS, said there’s a “huge disconnect” between the taxpayer-funded medical treatment system and the private-recovery facilities that evolved largely from peer-support systems.
“The reality is that a lot of (private-recovery facilities) don’t have the appropriate engagement with data and research and we need to integrate those so we make sure we’re doing what’s best for patients,” he said. “It’s a very complicated system that is not patient centred in any way. It needs to change.”
Ahamad laments a lack of regulation or standardization in treatment centres across B.C. But he believes the new Centre on Substance Use, headed by his colleague Dr. Evan Wood, will help solve this problem by bringing public and private systems together.
He believes this will provide evidence-based treatments and patient-centred care, so that a drug user with mental illness in Vancouver’s Downtown Eastside or a “lawyer who’s using drugs and surrounded by support systems” can both find the care they need — immediately.
“Right now, people are waiting months for treatment and that’s completely unacceptable,” Ahamad said. “The reality is that the introduction of illicit fentanyl into the drug trade has really ... illuminated this system that is totally dysfunctional and not able to respond to patients’ needs.”
The B.C. government has pledged to open 500 new substance-use beds by the end of 2017, bringing the provincial total to more than 1,600 beds. The Ministry of Health says it spends more than $1.42 billion each year on mental-health and substance-use services.